journal
Journals Critical Care Nursing Clinics ...

Critical Care Nursing Clinics of North America

https://read.qxmd.com/read/37838417/an-interprofessional-precision-health-model-for-assessment-of-caregiver-impact-on-polypharmacy-in-elderly-intensive-care-unit-patients-a-team-based-proposal
#21
REVIEW
Debbra Pogue, Mary O'Keefe
Elderly critical care patients are one of the largest growing patient population groups according to Medicare data. More than 51% of elderly patients are discharged on inappropriate medications that have the potential to cause harm or interact adversely with other medications. Precision health has the potential to prevent adverse drug events and prescription of inappropriate medications. The purpose of this literature review was to define the concept of precision health and determine the state of science regarding interprofessional models of precision health for assessment of caregiver impact on polypharmacy in elderly intensive care unit patients...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838416/the-role-and-initiatives-led-by-the-sepsis-coordinator-to-improve-sepsis-bundle-compliance-and-care-across-the-continuum
#22
REVIEW
Teresa Cranston, Katharine Thompson, Kathryn H Bowles
A dedicated sepsis coordinator role at Penn Medicine Lancaster General Hospital led initiatives to improve sepsis core measure compliance by 40% during the course of 4 years with submission of all sepsis cases. Chart abstraction and analysis of noncompliant cases identified areas for improvement: early recognition education, order set revisions, documentation support, and the implementation of a nurse-driven 24/7 sepsis monitoring process. The cooperative work with Penn Medicine affiliates, sharing best practices, improves overall sepsis bundle compliance and transitions of care...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838415/the-sensitive-care-of-the-elder-orphan-in-critical-care-environments
#23
REVIEW
Rebekah LaDuke, Jennifer Rotter
All patients within critical care units are vulnerable and many of them are unable to communicate their wishes and needs to the caregivers treating their acute critical illness. This inability to communicate is why interdisciplinary intensive care teams across the country heavily rely on spouses, children, siblings, parents, other next of kin, or other designated medical durable power of attorneys to advocate for those who cannot advocate for themselves. Unfortunately, there is a growing population of elder orphans who lack this support system when they need it the most...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838414/progressive-supranuclear-palsy-challenges-and-considerations-for-care-transitions
#24
REVIEW
Nadine Wodwaski
Progressive supranuclear palsy (PSP) is a fatal neurodegenerative disorder. Care requires a patient-centered approach encompassing compassion, communication, and empathy. Despite concerted actions to streamline PSP patient transitions, the care is multifaceted and cause of concern. Patients with PSP undergoing transitional care are at an increased risk of undesirable outcomes, frequently endure poor communication, and encounter inconsistent care. Therefore, patients with PSP and families worry about the uncertainty in care, including who is accountable for the care and available resources...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838413/biofilm-and-hospital-acquired-infections-in-older-adults
#25
REVIEW
Patricia Stevenson, Melissa Marguet, Matthew Regulski
Biofilm infections are a serious threat to public health, resistant to traditional treatments and host immune defenses. Biofilm infections are often polymicrobial, related to chronic wounds, medical devices (eg, knee replacements, catheters, tubes, contact lenses, or prosthetic valves) and chronic recurring diseases. Biofilms are more complex than nonadhered planktonic bacteria and produce a structure that prevents damage to the bacteria within the biofilm structure. The structure provides a hidden route to feed and nurture the bacteria allowing for ongoing spread of the bacteria...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838412/the-4m-model
#26
REVIEW
Jennifer M Manning
Engaging the health care team, including older adults and their caregivers, with the Institute for Healthcare Improvement 4M Model can help ensure every older adult receives (1) optimal health care, (2) is not harmed by health care, and (3) is satisfied with their health care. The evidence-based 4 Ms Model includes 4 significant concepts specific to older adult care: What matters, Mentation, Mobility, and Medication. Unfortunately, clinicians do not consistently apply the 4 Ms Model when caring for older adults...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37838411/do-we-really-listen-improving-end-of-life-conversations
#27
REVIEW
Cinnamon Brooke Tucker
Having end-of-life (EOL) conversations is often difficult for even seasoned clinicians. There are many well-developed conversation guidelines used in the specialty of palliative medicine. There is no one ultimate guide that makes having an emotion-filled conversation easy. However, using the tenets of medical ethics, cloaked with experience, compassion, empathy, and respect makes EOL conversations less traumatic for the patient-family system and for the provider. Palliative specialists have the training and experience in effectively having EOL conversations, especially when death is unavoidable...
December 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532389/pediatric-critical-care-nursing-our-past-present-and-future
#28
EDITORIAL
Melissa Nunn
No abstract text is available yet for this article.
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532388/battling-alarm-fatigue-in-the-pediatric-intensive-care-unit
#29
REVIEW
Heather Herrera, Danielle Wood
Pediatric intensive care unit nurses can be exposed to hundreds of alarms per patient they care for each shift. The exposure to so many alarms can cause nurses to be desensitized to future alarms and thus increase the time to respond to alarms. This is one of the largest patient safety concerns within health care today. Steps should be taken to mitigate the number of alarms nurses experience so that they can properly respond to actionable alarms.
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532387/asthma-care-protocol-implementation-in-the-pediatric-intensive-care-unit
#30
REVIEW
Exie Meredith, Jenilea Thomas
Asthma is a complex chronic disease characterized by inflammatory disorder causing airflow obstruction due to inflammation, bronchospasms, and mucus plugging. Children who fail to respond to initial first-line therapies often require hospitalization, and many with severe exacerbations and near-fatal asthma require admission to the pediatric intensive care unit (PICU). Nursing care of these PICU patients requires close monitoring and excellent assessment of their respiratory status. Administration of medications, such as albuterol, methylprednisolone, magnesium sulfate, and sedatives, is needed...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532386/nurse-led-rounds-in-the-pediatric-intensive-care-unit
#31
REVIEW
Lindsey Bird, Vanessa Kalis, Leah Apalodimas
Pediatric intensive care units (PICUs) rely on interprofessional communication and collaboration to mitigate the risk for medical error. To operationalize these tenets, many PICUs use multidisciplinary bedside rounds as the foundation of their workflow. Bedside nurse participation in rounds is inconsistent, diminishing the return on team investment in patient safety. Given this dilemma, some institutions have shifted from provider-led to nurse-led rounds. Here, the authors explore the rationale, experiences, and outcomes of implementation of nurse-led rounds within 4 PICU service lines...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532385/updates-and-clinical-implications-of-pediatric-delirium
#32
REVIEW
Lauren K Flagg, Jennifer A Mauney
Delirium is a fluctuating level of awareness based on a physiologic disease process. Within pediatrics, delirium affects approximately 30% of patients admitted to critical care units and is associated with increased mortality, morbidity, length of stay, and care costs. Multiple pediatric critical care societies recommend the implementation of screening practices using validated delirium tools. Delirium remains underrecognized because of suboptimal screening and protocol implementation in pediatric critical care units nationally and internationally...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532384/hematologic-and-oncologic-emergencies-in-the-pediatric-intensive-care-unit-what-nurses-should-know
#33
REVIEW
Danielle Sebbens, Jessica L Spruit
Most children admitted to the pediatric intensive care unit with a new or reoccurring hematology or oncology diagnosis are at high risk for developing a hematologic or oncologic emergency. Although these children represent a low percentage of pediatric critical care admissions, their acuity is high, and their care is complicated and challenging. Nurses are an essential part of the interprofessional team of providers who care for these critically ill patients. Experience recognizing acute decompensation and excellent assessment and communication skills significantly improve patient outcomes...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532383/unplanned-extubation-in-the-pediatric-intensive-care-unit
#34
REVIEW
Julianne Moss, Brieann Maurer, Cynthia Howes
Unplanned extubations (UEs) are common, potentially avoidable complications of endotracheal intubation among pediatric patients. UE can be associated with adverse patient outcomes including increased length of stay, hospitalization cost, and cardiorespiratory decompensation. Inconsistency in the definition of UE has led to underreporting. Staff must be able to recognize and intervene appropriately when an UE occurs. Risk factors have been identified and quality improvement initiatives aimed at reducing UE have shown to be effective in reducing the incidence...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532382/palliative-communication-in-the-pediatric-intensive-care-unit
#35
REVIEW
Stevia Davis, Melissa Nunn
Communication is a central aspect of nursing care and is especially important when pertaining to progressive illnesses and end of life. This article reviews basic palliative care terminology and outlines a variety of communication frameworks from the "dos" to the "don'ts." These communication strategies are meant to be added to the nurse's "toolbox" so that nurses may use them in various scenarios. These communication tools are meant to help mitigate the stress and discomfort nurses often feel when using palliative communication or delivering bad news...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532381/the-impact-of-end-of-life-care-among-nurses-working-in-the-pediatric-intensive-care-unit
#36
REVIEW
Benita N Chatmon, Dianne Richoux, Brittany Sweeney
Health care providers caring for patients at the end of life (EOL) are faced with a multitude of emotions such as guilt, anger, sadness, and helplessness. Because of the negative impact of initiating EOL care (EOLC) to the pediatric population, organizations must be proactive in instituting education and resources on EOLC. They must also provide advanced skills to nurses who take care of patients at their EOL. Understanding the consequences of providing EOL care to patients in the pediatric intensive care unit allows for better allocation of resources and support services for nurses...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532380/evolution-of-pediatric-critical-care-nursing
#37
REVIEW
Jackie Calhoun, Andrea Kline-Tilford, Judy Verger
Pediatric critical care nursing is a key pillar in patient care and outcomes for children who are ill and injured. Tremendous advances have occurred in pediatric critical care and nursing. This article provides an overview of the key advances in pediatric critical care nursing through the decades.
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532379/implementation-of-kangaroo-care-in-a-pediatric-cardiac-intensive-care-unit
#38
REVIEW
Sara T Lass, Melissa Nunn
With supporting the best neurodevelopmental outcomes possible, the doctor of nursing practice project was constructed. An educational program was created for nursing staff discussing the importance of kangaroo care and how to safely facilitate it in the intensive care setting. Following the education completion, kangaroo care was implemented. Data were collected exploring barriers to implementation, discharge on maternal breast milk, and parental feedback.
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37532378/acute-pain-management-protocols-in-pediatric-intensive-care-units
#39
REVIEW
Alicia Kleinhans
Pediatric pain has historically been difficult to assess and even more difficult to treat. It is encouraging that there is current research regarding pain control in pediatric patients that provide evidence for treating pediatric pain. Patients in a pediatric intensive care setting demonstrate a great deal of patient variability with regard to patient diagnosis, age, developmental level, weight, and amount of pain control needed. The use of an evidence-based protocol for pediatric pain control can decrease variability in pain control and decrease potential adverse effects such as respiratory depression, constipation, withdrawal, delirium, and developmental delays while allowing for patient variability...
September 2023: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/37127380/why-trauma-involves-many-issues
#40
EDITORIAL
Jeanette Vaughan, Whitney Villegas
No abstract text is available yet for this article.
June 2023: Critical Care Nursing Clinics of North America
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